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Health care associated infections, antibiotic resistance and clinical outcome: A surveillance study from Sanandaj, Iran

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World Journal of Clinical Cases 2016年第3期4卷 63-70页

作者： Jafar Soltani Bahman Poorabbas Neda Miri Jalal Mardaneh Department of Pediatrics Faculty of Medicine Kurdistan University of Medical Sciences Alborzi Clinical Microbiology Research Center Nemazee Hospital Shiraz University of Medical Sciences besat tertiary hospital Kurdistan University of Medical Sciences

AIM: To study the antibiotic susceptibility patterns of gram-negative healthcare associated bacterial infections at two tertiary hospitals in the Sanandaj city, Kurdistan Province, ***: From January 2012 to December 2012, all positive cultures from potentially sterile body fluids were gathered. They sent to professor Alborzi clinical microbiology center in Shiraz for further analysis and susceptibility testing. The antibiotic susceptibility was determined using the Kirby-Bauer method(disk diffusiontechnique). The Results were interpreted according to Clinical and Laboratory Standards Institute guidelines against a series of antimicrobials. World Health Organization definitions for Healthcare associated infections were ***: Seven hundred and thirty-two positive cultures were reported from both hospitals. Seventynine isolates/patients fulfilled the study criteria for healthcare associated gram-negative infections. The most frequent bacterial cultures were from the pediatric wards(52%). Serratia marcescens(S. marcescens)(38%) Escherichia coli(E. coli)(19%), Klebsiella pneumoniae(K. pneumoniae)(19%), Acinetobacter baumannii(6%), Enterobacter species(6%), Serratia odorifera(4%) and Pseudomonas species(5%) were the most frequently isolated organisms. The susceptibility pattern of common isolates i.e., S. marcescens, E. coli and K. pneumoniae for commonly used antibiotics were as follows: Ampicillin 3.3%, 6.7%, 20%; gentamicin 73.3%, 73.3%, 46.7%; ceftazidim 80%, 73.3%, 33.3%; cefepim 80%, 86.7%, 46.7%; piperacillin/tazobactam 90%, 66.7%, 86.7%; ciprofloxacin 100%, 73.3%, 86.7%; imipenem 100%, 100%, 100%, respectively. CONCLUSION: The most effective antibiotics against gram-negative healthcare associated infections are imipenem followed by ciprofloxacin. The resistance rate is high against ampicillin and cephalothin. The high mortality rate(46.1%) associated with S. marcescens is alarming.

关键词： Escherichia coli Klebsiella pneumoniae Serratia marcescens Extended-spectrum beta-lactamase Nosocomial infections Antibiotic susceptibility

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Return to work in young and middle-aged colorectal cancer survivors:Factors influencing self-efficacy,fear,resilience,and financial toxicity

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World Journal of Gastroenterology 2025年第1期31卷 79-92页

作者： Dan Hu Yue Li Hua Zhang Lian-Lian Wang Wen-Wen Liu Xin Yang Ming-Zhao Xiao Hao-Ling Zhang Juan Li Department of Nursing The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Nursing National Clinical Research Center for Child Health and DisordersMinistry of Education Key Laboratory of Child Development and DisordersChildren’s Hospital of Chongqing Medical UniversityChongqing 400014China Department of Gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Biomedical Science Advanced Medical and Dental InstituteUniversity Sains MalaysiaPenang 13200Malaysia Academic Affairs Office The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social ***,these survivors encounter significant challenges during their RTW ***,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC *** To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW *** A cross-sectional investigation was adopted in this *** September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in *** investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and *** analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were *** A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 *** regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further *** levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC *** professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.

关键词： Return to work Colorectal neoplasms Return-to-work self-efficacy Fear of progression Family resilience Financial toxicity

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Rising incidence of acute hepatitis A among adults and clinical characteristics in a tertiary care center of Pakistan

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World Journal of Virology 2025年第1期14卷 73-82页

作者： Yumna Shahid Amna Subhan Butt Iqra Jamali Faisal Wasim Ismail Division of Gastroenterology Department of MedicineAga Khan University HospitalKarachi 74800Pakistan Department of Medicine Aga Khan University HospitalKarachi 74800Pakistan

BACKGROUND For decades,hepatitis A virus(HAV)has been a leading cause of acute hepatitis among children and was less prevalent among ***,recently a paradigm shift has been observed in the epidemiology of HAV,as evident by cases of acute hepatitis due to HAV among *** To estimate frequency of HAV in acute viral hepatitis and compare characteristics in HAV and hepatitis E virus(HEV)*** This was a trend analysis conducted at Aga Khan University hospital Karachi(Sindh,Pakistan)from February 2024 to May *** aged 18 years and older diagnosed with acute viral hepatitis attributed to hepatotropic viruses in 2024 were *** compare the trend patients admitted with acute hepatitis during 2019-2023 were also *** regarding clinical and laboratory parameters were *** yearly trend of acute hepatitis due to HAV and HEV was analyzed,and comparative analysis was done between HAV and HEV cases among *** A total of 396 patients were found to have acute hepatitis during our study *** was diagnosed in 234 patients(59%)while 157 patients(39.6%)were found to have acute HEV ***,acute hepatitis B virus infection was identified in 3 patients(0.7%),whereas acute hepatitis C virus infection was found in 2(0.5%)cases of acute *** trends showed increasing occurrence of HAV infection among adults over last 5 *** patients with acute HAV were younger than patients with HEV(28 years±8 years vs 30 years±8 years;P<0.01).Higher levels of total bilirubin were seen in HEV infection,while higher levels of alanine transaminase were seen in HAV ***,a higher proportion of acute liver failure(ALF),coagulopathy,and mortality were observed in *** An increase in acute hepatitis A cases among adults shows less severity than hepatitis E,highlighting the need for better sanitation,hygiene,and adult hepatitis A vaccination programs.

关键词： Acute hepatitis Hepatitis A virus Hepatitis E virus Acute liver failure Hepatotropic virus Vaccination

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Prognostic factors for acute central retinal artery occlusion treated with hyperbaric oxygen:The Hong Kong study report number five

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World Journal of Methodology 2025年第2期15卷 117-124页

作者： Sunny Chi Lik Au Steffi Shing Yee Chong Department of Ophthalmology Tung Wah Eastern HospitalHong Kong 999077China Department of Ophthalmology Pamela Youde Nethersole Eastern HospitalHong Kong 999077China

BACKGROUND Central retinal artery occlusion(CRAO)is a potentially blinding disease,and hyperbaric oxygen therapy(HBOT)is becoming increasingly popular with the support of scientific *** the presence of various acute management measures,there is no clear evidence on the gold standard treatment for *** To identify factors and imaging parameters associated with good visual outcome,which guide ophthalmologists in the triage of CRAO patients for *** Patients who suffered from CRAO and had a symptom onset≤6 h were recruited for a course of HBOT in a tertiary hospital after failing bedside *** demographics,onset time,CRAO eye parameters,and past medical history were prospectively *** outcomes after HBOT were also *** A total of 26 patients were included;the female-to-male ratio was 1:1.6,and the mean age was 67.5 years±13.3 years(range 44–89 years).The mean duration of follow-up and mean visual acuity(VA)improvement were 10.0 mo±5.3 mo and 0.48 logarithm of minimal angle of resolution(logMAR)±0.57 logMAR(approx-imately 9 letters in ETDRS)(P=0.0001,Z=-3.67),*** 1 mm zone of central macular thickness(CMT)on optical coherence tomography was not associated with VA changes(P=0.119);however,the 1-to-3 mm circular rim of CMT was fairly associated(P=0.02,Spearman's coefficient=0.45).Complete retinal perfusion time during fundus fluorescein angiography(FFA)was mode-rately associated(P=0.01,Spearman's coefficient=0.58)with visual outcome.

关键词： Central retinal artery occlusion Fundus fluorescein angiography Hyperbaric oxygen therapy Optical coherence tomography Stroke

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A Rare Presentation of Popliteal Vein Aneurysm: Case Report

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Case Reports in Clinical Medicine 2017年第1期6卷 19-23页

作者： Ahmad Rezaee Azandaryani Pezhman Ghaderzadeh Leili Ebrahimi Farsangi Sayad Nasirzadeh Radiology Department Hamadan University of Medical Sciences Besat Hospital Hamadan Iran Alborz University of Medical Sciences Karaj Iran Hamadan University of Medical Sciences Besat Hospital Hamadan Iran

Popliteal venous aneurysms (PVAs) are very rare. More often it is an incidental finding found on duplex ultrasonography. Venous thrombosis and pulmonary emboli is the primary presentation in most cases of PVAs, hence it is a clinically significant abnormality and a potentially morbid and fatal condition. Early surgical repair should be performed immediately after the diagnosis is made because of the risk of pulmonary emboli. We report a case of symptomatic PVA presenting primarily with local symptoms and chronic pain in popliteal region.

关键词： Aneurysm Popliteal Vein

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An Extremely Rare Case Report of Foramen Magnum Dermoid Cyst Presenting as an Acute Progressive Neurologic Deficit

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Case Reports in Clinical Medicine 2020年第3期9卷 74-80页

作者： Ahmad Rezaee Azandaryani Mehrdad Taghipour Leili Ebrahimi Farsangi Radiology Department Hamadan University of Medical Sciences Besat Hospital Hamadan Iran General Surgery Department Hamadan University of Medical Sciences Besat Hospital Hamadan Iran Alborz University of Medical Sciences Shahid Rajaee Hospital Karaj Iran

Intracranial dermoid cysts are nonneoplastic lesions that present a rare clinical entity. They account for 0.04% to 0.6% of all intracranial tumors. Such cystic lesions usually contain different ectodermal derivatives including hairs, sebaceous glands, apocrine gland and teeth. Dermoid cysts of foramen magnum occur very rarely, with few cases reported in the literature. Computed tomography (CT) and magnetic resonance imaging (MRI) are two main diagnostic tools. Here in this paper, we described a case of intracranial (foramen magnum) dermoid cyst presented with neurologic deficits that completely removed surgically.

关键词： Cyst Dermoid Foramen Magnum Radiology

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How aging affects bone health via the intestinal micro-environment

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BIOCELL 2024年第3期48卷 353-362页

作者： HUAN HU YUE HUANG FANGZHOU LIU QIAN WANG YANZI YAO School of Stomatology Zunyi Medical UniversityZunyiChina Microbial Resources and Drug Development Key Laboratory of Guizhou tertiary Institution Zunyi Medical UniversityZunyiChina Department of Stomatology Luoyang Maternal and Child Health HospitalLuoyangChina

Increasing life expectancy and an aging population lead to age-related bone diseases like osteoporosis and low bone mass more *** conditions represent a common,costly and chronic burden,not only for elderly but also to society at ***,elucidating the pathophysiology and developing effective therapies for these diseases is of paramount *** advances in research have identiﬁed the gut as a novel and promising target for addressing bone disorders,giving rise to the concept of the“gut-bone axis”.An in-depth review of the latest insights into the effects of age-related physiological changes in the gastrointestinal tract on bone health is presented in this *** examines how the“gut-bone”axis interacts with bone aging across various domains,including metabolism,nutrition,intestinal permeability,immunity,and oxidative stress.

关键词： Gut barrier Skeletal system Senescent Gut-bone axis Gut microbiota

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Evaluation of a Possible Effect of In-House Cryoprecipitate Transfusion on Outcome of Severe Upper Gastrointestinal Bleeding: A Retrospective Cohort Study

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Open Journal of Blood Diseases 2019年第1期9卷 20-29页

作者： Hiroshi Fujita Shigeko Nishimura Kazuhiro Sugiyama Department of Transfusion Medicine Tokyo Metropolitan Bokutoh Hospital Tokyo Japan tertiary Emergency Medical Center Tokyo Metropolitan Bokutoh Hospital Tokyo Japan

Purposes: Hypofibrinogenemia is usually complicated with severe and massive upper gastrointestinal (GI) bleeding, especially in liver cirrhosis. In Japan, neither fibrinogen concentrate nor cryoprecipitate (CRYO) is available for cases of acquired hypofibrinogenemia to recover the hemostatic level of fibrinogen rapidly. We prepared and produced in-house CRYO from fresh frozen plasma, and compared mortality between pre-implementation and post-implementation of CRYO. Methods: We performed a retrospective cohort study of patients admitted to our single tertiary medical center with upper GI bleeding from January 2011 to December 2016. The observational control period was from January 2011 to February 2013. From March 2013 to December 2016, we implemented the transfusion of CRYO, which was prepared and produced in our hospital. Clinical outcomes were compared between the patients in the two periods. Patients: Eleven patients in the control period and 10 in the intervention period were eligible for analysis. Results: In-hospital mortality (55% vs. 20%, P = 0.238) and mortality within 24 hour after admission (27% vs. 0%, P = 0.246) tended to be lower in the intervention period than in the control period, although the patients had more severe coagulation on admission than those in the control period. The plasma fibrinogen level before the treatment of hemostasis in the intervention period was higher than that in the control period (80 ± 9 mg/dL vs. 127 ± 15 mg/dL, P Conclusion: Implementation of in-house CRYO transfusion may reduce the rate of mortality due to severe upper GI bleeding.

关键词： Esophageal Varix Resuscitation Mortality Hypofibrinogenemia

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Intravesical Migration of Intrauterine Device and Calculi Formation 12 Years Post Missing: A Case Report

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Case Reports in Clinical Medicine 2017年第1期6卷 24-30页

作者： Ahmad Rezaee Azandaryani Pezhman Ghaderzadeh Leili Ebrahimi Farsangi Radiology Department Hamadan University of Medical Sciences Besat Hospital Hamadan Iran Cardiology Department Alborz University of Medical Sciences Karaj Iran

Intraunterine device (IUD) is a safe, effective and feasible method used for reversible contraception worldwide. Transvesical migration of an Intrauterine device (IUD) is a rare complication. We describe a case in whom initially a plain abdominopelvic radiography demonstrated calcified string of an IUD in a 42-year-old woman with recurrent lower urinary symptoms (LUTS) and urinary tract infection since 2 years earlier. The IUD had been inserted 12 years earlier and 3 years after placement of the IUD, the patient experienced an uneventful pregnancy and a successful delivery. Sonographic images and later on the cystoscopic procedure confirmed the diagnosis of transvesical migration of the IUD. The IUD was removed using cystoscopic procedure, leaving no complication.

关键词： Bladder Stone Intrauterine Contraceptive Device Intravesical Migration

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Transanal eco-Doppler evaluation after hemorrhoidal artery embolization

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World Journal of Gastroenterology 2024年第17期30卷 2332-2342页

作者： Roberta Tutino Tommaso Stecca Fabrizio Farneti Marco Massani Giulio Aniello Santoro Dipartimento Chirurgia Generale e Specialistica AOU Cittàdella Salute e della Scienza di TorinoTorino 10126Italy Division of General Surgery 1 Treviso Regional HospitalAULSS 2 Marca TrevigianaTreviso 31100Italy Division of Radiology Treviso Regional HospitalAULSS 2 Marca TrevigianaTreviso 31100Italy tertiary Referral Pelvic Floor Center Division of General Surgery 2AULSS 2 Marca TrevigianaTreviso 31100Italy

BACKGROUND Hemorrhoidal artery embolization(Emborrhoid)is a novel method for the treatment of severe hemorrhoidal *** having a technical success rate of 93%-100%,the clinical success ranges between 63%and 94%,with a rebleeding rate of 13.6%.AIM To evaluate the effectiveness of this procedure in reducing hemorrhoidal flow and hemorrhoidal *** This prospective observational pilot study was conducted at Division of General Surgery 1 and tertiary Referral Pelvic Floor Center,Treviso Regional hospital,*** a 2 months period(February-March 2022),consecutive patients with hemorrhoidal bleeding scores(HBSs)≥4,Goligher scores of II or III,failure of non-operative management,and a candidate for Emborrhoid were *** ultrasound with eco-Doppler was performed preoperatively and 1 month after the *** primary endpoint was to quantify the changes in arterial hemorrhoidal flow after *** secondary endpoint was to evaluate the correlation between the flow changes and the *** Eleven patients underwent *** overall pretreatment mean systolic peak(MSP)was 14.66 cm/*** highest MSP values were found in the anterior left lateral(17.82 cm/s at 1 o’clock and 15.88 cm/s at 3 o’clock)and in the posterior right lateral(14.62 cm/s at 7 o’clock and 16.71 cm/s at 9 o’clock)quadrants of the anal *** treatment,the overall MSP values were significantly reduced(P=0.008)although the correlation between MSP and HBS changes was weak(P=0.570).A statistical difference was found between distal embolization compared with proximal embolization(P=0.047).However,the coil landing zone was not related to symptoms improvement(P=1.000).A significant difference in MSP changes was also reported between patients with type 1 and type 2 superior rectal artery(SRA)anatomy(P=0.040).No relationship between hemorrhoidal grades(P=1.000),SRA anatomy(P=1.000)and treatment outcomes was *** The preliminary findings of this pilo

关键词： Hemorrhoidal artery embolization Hemorrhoidal embolization Hemorrhoidal vascularization Transanal eco-Doppler Transanal ultrasound

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